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Acid–Base and Electrolyte Changes Drive Early Pathology in Ischemic Stroke

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Abstract

Emergent large vessel occlusion accounts for 20–40% of ischemic strokes and is the most debilitating form of stroke. Some of the earliest changes in response to ischemic stroke occur in blood gases and electrolytes. These biochemical changes occur within minutes after occlusion in experimental models of stroke and can be utilized to predict stroke outcomes. The majority of ELVO stroke patients are middle-aged to elderly and are of both sexes, revealing that there is an age and sex mismatch between ischemic stroke patients and animal models, since most experimental studies use young male rats. Rethinking of the animal models should be considered, especially in encouraging the use of aged male and female rats with comorbidities to more closely mirror human populations. Mechanical thrombectomy provides a unique opportunity for researchers to further this work by expanding the collection and analysis of blood samples that are adjacent to the thrombus. To understand the complexity of stroke, researchers can analyze these tissues for different molecular targets that occur in response to ischemic stroke. This information may aid in the reduction of symptom burden for individuals diagnosed with ischemic stroke. Investigators should also focus on data from ischemic stroke patients and attempt to discover target molecules and then in animal models to establish mechanism, which will aid in the development of new stroke therapies. This review discusses the translation of these studies to the human patient to develop the capability to predict stroke outcomes. Future studies are needed to identify molecular targets to predict the risk of worsened long-term outcomes and/or increased risk for mortality.

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Acknowledgements

The authors would like to thank Tom Dolan for the graphics in Fig. 1.

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Authors and Affiliations

  1. College of Nursing, University of Kentucky, Lexington, KY, USA

    Sarah R. Martha

  2. Department of Neurology, University of Kentucky, Center for Advanced Translational Stroke Science, Building BBSRB, Office B377, Lexington, KY, 40536, USA

    Justin F. Fraser & Keith R. Pennypacker

  3. Department of Neurosurgery, University of Kentucky, Lexington, KY, USA

    Justin F. Fraser

  4. Department of Neuroscience, University of Kentucky, Lexington, KY, USA

    Justin F. Fraser & Keith R. Pennypacker

  5. Department of Radiology, University of Kentucky, Lexington, KY, USA

    Justin F. Fraser

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  1. Sarah R. Martha
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Correspondence to Keith R. Pennypacker.

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All procedures performed in studies involving animals were in accordance with the ethical standards of the institution or practice at which the studies were conducted. (IACUC 2016-2356).

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Martha, S.R., Fraser, J.F. & Pennypacker, K.R. Acid–Base and Electrolyte Changes Drive Early Pathology in Ischemic Stroke. Neuromol Med 21, 540–545 (2019). https://doi.org/10.1007/s12017-019-08555-5

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