3 ISC NEWS DAY 2 | THURSDAY, FEBRUARY 6, 2025 StrokeConference.org #ISC25 Intracranial hemorrhage is one of the most dangerous types of stroke, with a devastating mortality rate. Understanding the role of inflammation in intracranial hemorrhage may be a critical step toward improving treatments and bringing those death rates down. That will be the crux of the session on Thursday titled “Bench to Bedside and Beyond — What Do We Know About the Role of Inflammation in an Intracranial Hemorrhage?” In managing intracranial hemorrhages, the impact of vascular permeability is an important, related question, said Sahily Reyes-Esteves, MD, PhD, neurology instructor at the University of Pennsylvania’s Perelman School of Medicine. “Intracranial hemorrhages inherently cause a breakdown of the blood-brain barrier and a spillage of blood contents into the brain parenchyma,” Reyes-Esteves said. “However, beyond the initial hematoma, we have learned that there are persistent waves of barrier leakiness that contribute to the inflammatory response” after the hemorrhage. “Is it all bad? Is it all good? The answer is probably somewhere in the middle,” she said. “Understanding the nuances in this balance is important to understanding how vascular permeability affects outcomes after intracranial hemorrhage.” Reyes-Esteves will discuss those questions and more in her presentation, “The Role of Vascular Permeability in Neuroinflammation After Intracranial Hemorrhage.” She said vascular permeability’s impact is the subject of much research. “Clinically, we have long observed that cerebral edema after intracranial hemorrhage is associated with worse outcomes,” she said. “Does vascular permeability inherently lead to edema and bad outcomes? Perhaps not. Current research is looking to understand the role of the peripheral and brain intrinsic immune response in vascular permeability after intracranial hemorrhage and how it impacts ‘good’ or ‘bad’ healing.” The difference between that “good” and “bad” healing is not as black-andwhite as it seems. There has long been an impression that the inflammatory response after intracranial hemorrhage was all bad, Reyes-Esteves said, but that may not be the case. “I think it is important as clinicians to understand not just the detrimental effects of inflammation, but the potentially beneficial ones as well, as they can inform the development of new therapies that harness the immune response for brain healing,” she said. Also at Thursday’s session, a researcher will describe a novel drug candidate that could decrease inflammation and cerebral edema in the wake of intracerebral hemorrhage – which is a subset of intracranial hemorrhage. Linda Van Eldik, PhD, director of the Sanders-Brown Bench to Bedside and Beyond — What Do We Know About the Role of Inflammation in an Intracranial Hemorrhage? 7:30-9 a.m. | Thursday, Feb. 6 Room 152 UPCOMING SESSION Reyes-Esteves Eldik see INFLAMMATION, page 13 Intracranial hemorrhage and inflammation Research on vascular permeability, drug candidate provides insights into this life-threatening event.
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