Highlights d Reperfusion failure despite clot retrieval leads to unfavorable outcome in stroke d In the thrombin model of stroke, z30% capillaries remain occluded after thrombolysis d Capillaries are plugged by neutrophils, hindering blood flow d Neutrophil depletion facilitates capillary reperfusion and stroke recovery

Background and Purpose-We investigated whether transient ischemic attacks (TIAs) before stroke can induce tolerance by raising the threshold of tissue vulnerability in the human brain. Methods-Sixty-five patients with first-ever ischemic territorial stroke received diffusion-and perfusion-weighted MRI within 12 hours of symptom onset. Epidemiological and clinical data, lesion volumes in T2, apparent diffusion coefficient (ADC) maps and perfusion maps, and cerebral blood flow and cerebral blood volume values were compared between patients with and without a prodromal TIA. Results-Despite similar size and severity of the perfusion deficit, initial diffusion lesions tended to be smaller and final infarct volumes were significantly reduced (final T2: 9.

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