After an ischemic stroke, how long does it usually take for the brain swelling to peak & subside?

I am asking this question for the case of a large ischemic stroke in which around 2/3 of the left side of the brain has been impaired. Presumably it takes longer for the brain swelling to subside for a large stroke than a minor stroke.

A follow-up question is, what is the mechanism by which the brain swelling subsides? Does the swelling subside only due to the death of brain cells?

Hi.

After an ischemic stroke, there are actually two types of brain swelling(aka cerebral edema) that occur.

1. First, there is intracellular edema, which is also called cytotoxic edema. When a brain cell's oxygen supply is interrupted, the cell is no longer able to regulate the concentration of its own electrolytes. As a result, while the cell is dying, water rushes into the cell from extracellular compartments. This event occurs within a few hours (2-3 hrs) after the stroke happens.

2. The second type of edema is called vasogenic edema (aka interstitial edema) and occurs later than cytotoxic edema. In this case, after an ischemic stroke, the blood vessels downstream break down and begin to leak water and proteins into the area of dead brain. These events occur with 6-12 hours and progresses for about 3 days.

When someone has a large stroke, it is the rapid progression of interstitial edema that is potentially lethal. The estimated peak of interstitial edema is about 3 days, but more realistically it is about 3-5 days.

Eventually as the neurons and its supporting cells die off and are replaced with scar tissue, the cytotoxic edema subsides. Also, as the blood vessels repair themselves or either die off, the leakiness of the blood vessels subside as well. Thus, to answer your question, the resolution of swelling is not directly due to the death of neurons, but it is due rather to the decrease of inflammation and the gradual repair of the blood vessels.

Hope I was able to answer your question!

Two great sites that I've found are www.strokecenter.org and http://www.healthline.com/sw/h... which has the best sections on diagnosing and treating ischemic stroke that I've found so far. Report It

You mean a paralytic stroke?
Practically there is little cure for a paralysis arising out of a stroke (ie., cerebral thrombosis).
A brain cell once dead means it is permanently dead!