PerspectiveNEUROPHYSIOLOGY

Opening the floodgates to the brain

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Science  13 Mar 2020:
Vol. 367, Issue 6483, pp. 1195-1196
DOI: 10.1126/science.aba8801

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Summary

Cerebral edema, brain swelling due to fluid influx, exacerbates the effects of ischemic large-vessel stroke, whereby a clot blocks one of the large blood vessels to the brain. Because the skull is a closed box, brain swelling cannot be accommodated, damaging other areas of the brain and leading to poor long-term prognoses (1). The central dogma to this fluid influx is that its source is the blood. On page 1211 of this issue, Mestre et al. (2) present compelling evidence to suggest that the initial stages of cerebral edema after ischemic stroke are driven by influx from an alternative source—the cerebrospinal fluid (CSF). This implies that targeting CSF-driven edema may offer opportunities to treat these harmful secondary effects of ischemic stroke.

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