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Sleep-disordered breathing and arterial blood flow steal represent linked therapeutic targets in cerebral ischaemia

Authors

  • Kristian Barlinn,

    Corresponding author
    1. Department of Neurology, Dresden University Stroke Center, University of Technology Dresden, Dresden, Germany
    2. Comprehensive Stroke Center, University of Alabama Hospital, Birmingham, AL, USA
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  • Andrei V. Alexandrov

    1. Comprehensive Stroke Center, University of Alabama Hospital, Birmingham, AL, USA
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  • Conflict of interest: None declared.

  • Disclosures: None.

Kristian Barlinn*, Department of Neurology, Dresden University Stroke Center, University of Technology Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
E-mail: Kristian.Barlinn@uniklinikum-dresden.de

Abstract

The pathogenic link between sleep-disordered breathing and early neurological deterioration in acute ischaemic stroke patients is now a subject of clinical investigations. Vasomotor reactivity and intracranial blood flow steal in response to changing vasodilatory stimuli like carbon dioxide play a pivotal role in clinical deterioration with reversed Robin Hood syndrome. A mechanical ventilatory correction in selected acute stroke patients might have a beneficial effect on sleep-disordered breathing and brain perfusion. This is a novel therapeutic target and the missing link in the pathogenesis of early neurological deterioration and stroke recurrence.

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