Inflammation in ischemic stroke: Mechanisms, diagnosis and management

Inflammation plays an important role in ischemic stroke, not only in the development of atherosclerotic lesions, but also in the processes that lead to apoptosis and further neurological insults following stroke. Interestingly, inflammation also plays an important role in repair and recovery following stroke. This chapter will describe the pathophysiological basis of the inflammatory processes that lead to ischemic injury, the diagnostic imaging modalities (CT, MRI, SPECT, near-infrared fluorescence, etc.) available to predict inflammatory plaque rupture and subsequent thrombosis before it occurs, and the modulation of inflammatory mediators to prevent the spread of stroke and aid in recovery once the insult has developed. The role of the various inflammatory cytokines in cell death and proliferation after ischemia, the integrity of the blood-brain barrier, and the prevention and treatment of stroke will be mentioned. The challenges facing lifestyle modifications as well as prevention of ischemic stroke using current knowledge of the inflammatory processes involved in ischemia will be briefly discussed. Finally, the currently available as well as potential future treatments for ischemic stroke, rehabilitation and general neuroprotection will be discussed. Both conventional and alternative modalities of inflammatory modulation for neuroprotection and neurogenesis following ischemia will be described.