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Nandan Lad: Microclots as the Cause of Secondary Stroke After Subarachnoid Hemorrhage
Jun 5, 2026, 18:36

Nandan Lad: Microclots as the Cause of Secondary Stroke After Subarachnoid Hemorrhage

Nandan Lad, Professor at Duke University Medical Center, Co-Founder of Pharaoh Neuro, shared a post on LinkedIn about a recent article by Ari Dienel et al., published in Experimental and Molecular Medicine, adding:

“When a brain aneurysm bursts, the bleeding and stroke is just the first injury.

Days later, a second one shows up. Half the survivors of subarachnoid hemorrhage – the deadliest kind of stroke – develop secondary strokes and delayed neurological deficits, 4 to 10 days after the rupture.

For 50 years, we’ve tried antiplatelet drugs (the same ones that prevent regular strokes) to stop it. Some trials helped. Some didn’t. The field stayed stuck.

A new paper in Nature Experimental and Molecular Medicine from UTHealth Houston by Devin McBride, H Alex Choi, Spiros Blackburn and team just resolved it. The cause: microclots. Tiny clots on the brain’s smallest blood vessels – too small to see on a routine scan.

Activating platelets leads to more microclots, worse outcomes

Depleting platelets leads to fewer microclots, better outcomes

After years of guessing, a multi-pronged target that includes cells, platelets and their downstream pathways emerges.”

Proceed to the video attached to the post.

Title: Platelets cause microvascular occlusion and delayed neurological deficits after subarachnoid hemorrhage in mice

Authors: Ari Dienel, Sung-Ha Hong, Kiara Torres, Kanako Matsumura, Jose Guzman, Peeyush Thankamani Pandit, Bibek Samal, Harveen Kaur, Samitha Nemirajaiah, Angelica Bernal, H. Alex Choi, Louise D. McCullough, Spiros L. Blackburn, Jaroslaw Aronowski, Devin W. McBride

Nandan Lad

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