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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
06:01

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

Mixed cerebrovascular disease and the future of stroke prevention

Mark Fisher, Vitaly Vasilevko, David H Cribbs

    Translational Stroke Research
    |June 19, 2012
    PubMed

    Insights

    Stroke prevention needs to address mixed cerebrovascular disease, encompassing both ischemic and hemorrhagic conditions. This unified approach aids risk stratification and identifies therapies like PDE inhibitors for comprehensive stroke care.

    Area of Science:

    • Neurology
    • Cerebrovascular Disease Research
    • Pharmacology

    Background:

    • Current stroke prevention strategies often focus narrowly on either ischemic or hemorrhagic stroke.
    • This singular focus is insufficient due to the common co-occurrence of both ischemic and hemorrhagic conditions in patients.
    • This co-occurrence, termed mixed cerebrovascular disease, necessitates a more integrated approach to prevention and treatment.

    Purpose of the Study:

    • To introduce and advocate for the concept of "mixed cerebrovascular disease" as a unifying framework for stroke prevention.
    • To highlight the clinical and subclinical syndromes encompassed by mixed cerebrovascular disease.
    • To explore potential therapeutic strategies, such as phosphodiesterase (PDE) inhibitors, for managing this complex condition.

    Main Methods:

    • Review and synthesis of existing literature on ischemic and hemorrhagic stroke.
    • Identification of clinical and subclinical syndromes associated with mixed cerebrovascular disease.
    • Exploration of animal models for understanding hemorrhagic cerebrovascular disease mechanisms.
    • Evaluation of therapeutic agents, specifically PDE inhibitors, for their dual-action potential.

    Main Results:

    • Mixed cerebrovascular disease includes conditions like ischemic stroke, subclinical infarcts, leukoaraiosis, intracerebral hemorrhage, and cerebral microbleeds.
    • Recognizing mixed cerebrovascular disease can improve risk stratification for hemorrhagic complications from antiplatelet and anticoagulant therapies.
    • Animal models of cerebral amyloid angiopathy and hypertension provide insights into hemorrhagic stroke mechanisms.
    • Phosphodiesterase (PDE) inhibitors show promise due to their ability to target both platelets and the vessel wall.

    Conclusions:

    • A "mixed cerebrovascular disease" framework offers a more comprehensive approach to stroke prevention than focusing on single stroke types.
    • This framework aids in assessing risks associated with antithrombotic therapies.
    • Targeting mechanisms underlying mixed cerebrovascular disease, potentially with agents like PDE inhibitors, is crucial for effective stroke prevention.

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