STROKE PATHOPHYSIOLOGY AND TREATMENT: CURRENT SITUATION AND PROSPECTS

Akanksha Jadhav*, Ratnadeep Pawar, Mahesh Pawar and Dr. Malpani S. G.

Stroke, a significant neurological disorder, results from interrupted blood flow to the brain, causing neuronal death and leading to severe consequences such as disability, dementia, and mortality. The recent reclassification of stroke as a neurological disease in ICD-11 has enhanced research funding and improved clinical documentation. Globally, stroke ranks as the second leading cause of death, with ischemic stroke comprising 87% of cases. Its incidence varies by geography, gender, and socioeconomic status, with lower-income countries bearing a disproportionate burden. Stroke pathophysiology involves ischemic core cell death and salvageable penumbra regions, influenced by mechanisms such as excitotoxicity, oxidative stress, neuroinflammation, apoptosis, and autophagy. Emerging cell death pathways like ferroptosis, phagoptosis, and pyroptosis also play critical roles. Identified risk factors include hypertension, diabetes, and atrial fibrillation, alongside age and sex-specific differences. Prevention strategies emphasize controlling modifiable risk factors, while treatment has progressed through thrombolytics, calcium channel blockers, antioxidants, and neuroprotective agents. Advances in rehabilitation and animal models provide insights into stroke recovery and regenerative therapies. Despite these strides, translating research into clinical settings remains a challenge. Future priorities include collaborative research, improved preclinical models, and innovative therapeutic strategies to address the growing global stroke burden.