脑水肿是缺血性中风最为严重的后果之一，恶性脑水肿是大半球中风高死亡率的主要原因。尽管几十年来已经做出了大量努力来阐明缺血性脑水肿形成的机制并寻找治疗靶点，但目前对于缺血性脑水肿的治疗仍然主要是缓解症状，而不是旨在阻止水肿的形成和进展。最近的前临床研究揭示了缺血性脑缺血再灌注后水肿形成的新的细胞机制。神经影像技术的进步也为早期诊断和预测中风患者的恶性脑水肿开辟了机会，以便迅速采取挽救生命的手术干预。随着再灌注治疗在临床实践中的越来越广泛应用，了解治疗再灌注如何影响缺血性中风后脑水肿的形成对于决策和再灌注后的管理至关重要。在本研究中，我们总结了过去十年对于细胞机制、评估、预测和干预缺血性脑水肿在临床环境中的研究进展，旨在为未来关于中风后脑水肿的诊断和治疗的前临床和临床研究提供思路。版权所有 © 2023作者。由Elsevier Inc.出版。保留所有权利。

Brain edema is one of the most devastating consequences of ischemic stroke. Malignant cerebral edema is the main reason accounting for the high mortality rate of large hemispheric strokes. Despite decades of tremendous efforts to elucidate mechanisms underlying the formation of ischemic brain edema and search for therapeutic targets, current treatments for ischemic brain edema remain largely symptom-relieving rather than aiming to stop the formation and progression of edema. Recent preclinical research reveals novel cellular mechanisms underlying edema formation after brain ischemia and reperfusion. Advancement in neuroimaging techniques also offers opportunities for early diagnosis and prediction of malignant brain edema in stroke patients to rapidly adopt life-saving surgical interventions. As reperfusion therapies become increasingly used in clinical practice, understanding how therapeutic reperfusion influences the formation of cerebral edema after ischemic stroke is critical for decision-making and post-reperfusion management. In this review, we summarize these research advances in the past decade on the cellular mechanisms, and evaluation, prediction, and intervention of ischemic brain edema in clinical settings, aiming to provide insight into future preclinical and clinical research on the diagnosis and treatment of brain edema after stroke.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.