Brain Cleanup after ICH as Mechanism of Repair and Recovery

Abstract

No pharmacological approach aimed at improving post-stroke recovery has shown therapeutic efficacy in clinical trials. One of the most promising strategies is to improve the clearance of cytotoxic blood and cellular debris from the affected brain because RBC lysis products (hemoglobin/heme) and dead, lingering tissue acts as a “reservoir” for pro-inflammatory responses and poses physical barriers impeding neuronal re-connectivity. Cleanup of the of the brain from hematoma and removal of dead tissue is normally conducted by microglia/macrophage, cells that are equipped with specialized receptors recognizing molecules that are foreign and modified to ensure their removal and prevent their harmful effects. This lecture will focus on an understudied area of post-stroke (ischemic and hemorrhagic) recovery – the importance of clearing to facilitate the repair processes. Various clinically targetable mechanisms will be discussed.