title: Blood-brain barrier breakdown and neovascularization processes after stroke and traumatic brain injury.
abstract: OBJECTIVE
  Angiogenesis or vascular reorganization plays a role in recovery after stroke and traumatic brain injury (TBI). In this review, we have focused on two major events that occur during stroke and TBI from a vascular perspective - what is the process and time course of blood-brain barrier (BBB) breakdown? and how does the surrounding vasculature recover and facilitate repair?
  
  
  RESULTS
  Despite differences in the primary injury, the BBB changes overlap between stroke and TBI. Disruption of BBB involves a series of events: formation of caveolae, trans and paracellular disruption, tight junction breakdown and vascular disruption. Confounding factors that need careful assessment and standardization are the severity, duration and extent of the stroke and TBI that influences BBB disruption. Vascular repair proceeds through long-term neovascularization processes: angiogenesis, arteriogenesis and vasculogenesis. Enhancing each of these processes may impart beneficial effects in endogenous recovery.
  
  
  CONCLUSIONS
  Our understanding of BBB breakdown acutely after the cerebrovascular injury has come a long way; however, we lack a clear understanding of the course of BBB disruption and BBB recovery and the evolution of individual cellular events associated with BBB change. Neovascularization responses have been widely studied in stroke for their role in functional recovery but the role of vascular reorganization after TBI in recovery is much less defined.
authors.affiliation: Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
authors.forename: Roshini
authors.initials: R
authors.lastname: Prakash
authors.forename: S Thomas
authors.initials: ST
authors.lastname: Carmichael
mesh_terms: D001812:Blood-Brain Barrier / Q000502:physiology* / Q000503:physiopathology*; D001930:Brain Injuries / Q000503:physiopathology*; D006801:Humans; D018919:Neovascularization, Physiologic / Q000502:physiology*; D020521:Stroke / Q000503:physiopathology*