By the time you see your doctor in weeks/months/years s/he should already have figured out how to activate the Plasminogen Activation System. Because you need dendritic spine growth to advance your recovery. If your doctor doesn't have a protocol for that setup then you need to call the hospital president and ask WHAT THE HELL IS YOUR STROKE DOCTOR'S GOALS?
Abstract
Advances in
neurocritical care and interventional neuroradiology have led to a
significant decrease in acute ischemic stroke (AIS) mortality. In
contrast, due to the lack of an effective therapeutic strategy to
promote neuronal recovery among AIS survivors, cerebral ischemia is
still a leading cause of disability in the world. Ischemic stroke has a
harmful impact on synaptic structure and function, and
plasticity-mediated synaptic recovery is associated with neurological
improvement following an AIS. Dendritic spines (DSs) are specialized
dendritic protrusions that receive most of the excitatory input in the
brain. The deleterious effect of cerebral ischemia on DSs morphology and
function has been associated with impaired synaptic transmission and
neurological deterioration. However, these changes are reversible if
cerebral blood flow is restored on time, and this recovery has been
associated with neurological improvement following an AIS. Tissue-type
plasminogen activator (tPA) and urokinase-type plasminogen activator
(uPA) are two serine proteases that, besides catalyzing the conversion
of plasminogen into plasmin in the intravascular and pericellular
environment, respectively, are also efficient inductors of synaptic
plasticity. Accordingly, recent evidence indicates that both, tPA and
uPA, protect DSs from the metabolic stress associated with the ischemic
injury, and promote their morphological and functional recovery during
the recovery phase from an AIS. Here, we will review data indicating
that plasticity-induced changes in DSs and the associated post-synaptic
density play a pivotal role in the recovery process from AIS, making
special emphasis on the role of tPA and uPA in this process.
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