One of the major culprit is the Cerebral edema after the stroke which doesn't help these drugs and is a major hinderance.
One of the new major area in stroke to work is finding a drug to increase the collateral circulation with the exisiting vessels around the blocked vessel in the brain because brain is well perfused. It's similar to the mechanism of vessel blockage in the heart and bypassing it with collateral circulation but much complicated in the brain to achieve.
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