Hemorrhagic stroke causes not only direct brain damage but also triggers secondary injuries, including axonal degeneration (AxD). This systematic review screened 817 publications and analyzed 68 studies to provide a comprehensive overview of AxD in both patients and animal models.

Highlights of the findings include:

• AxD can be detected as early as 6 hours after hemorrhagic stroke
• Biomarkers such as neurofilaments, tau, and beta-amyloid precursor protein are linked to AxD
• Diffusion MRI reveals white matter disruption associated with axonal damage
• AxD is associated with poor clinical outcomes
• Therapeutic approaches targeting neuroinflammation, energy metabolism, and axonal repair may hold promise

This review advances our understanding of axonal degeneration as a key secondary injury mechanism and identifies potential therapeutic targets for future research.

The study was carried out in the group of Ass.-Prof. Marietta Zille, PhD together with former lab member Lamija Hadziavdic and Marietta’s long-term collaborator Tracy D. Farr from the University of Edinburgh.

View at publisher: https://doi.org/10.1016/j.phrs.2025.107946. 

Amir Pasokh, Lamija Hadziavdic, Tracy D. Farr, Marietta Zille, "Axonal degeneration in hemorrhagic stroke: A systematic review", in Pharmacological Research, Volume 220, 2025, 107946.