Histopathological and ultrastructural changes in different cell types during ischemic and hemorrhagic stroke

Stroke is a disease of the central nervous system that leads to high rates of morbidity and mortality, along with limited treatment options. This condition is frequently linked to pathologic alterations at the ultrastructural level within diverse neuronal components, including cell bodies, neurites, and synapses, as well as in glial cells like astrocytes, microglia, and oligodendrocytes. These changes include alterations in the shape and size of cell bodies, disruption of neurites, and changes in the density and distribution of synapses. The blood-brain barrier, a crucial component of the brain's defense system, is also compromised following a stroke, leading to further complications. Although stroke research has significantly advanced, there is still a lack of comprehensive reviews on ultrastructural pathological changes. Given the current challenges in treating stroke, identifying dynamic subcellular structural changes can improve our understanding of the complex pathologic processes after a stroke, ultimately enhancing clinical diagnosis and therapeutic strategies. This review aims to summarize and analyze the ultrastructural changes documented through transmission electron microscopy in both ischemic and hemorrhagic stroke, providing insights for future research and developing novel treatments.