Is stroke reversible? Brain cells do not regenerate after a stroke. However, the brain can compensate for damaged areas through a process called neuroplasticity.  Neuroplasticity is the brain’s ability to rewire itself and use healthy brain tissue to take on lost functions. 

Here are some ways the brain compensates for damaged areas after a stroke: 

• Neuroplasticity
  The brain rewires neural pathways to compensate for damaged areas. This process can be activated through repetition and consistency. For example, a stroke survivor can practice leg exercises to improve the brain’s ability to send signals to the leg. 
  b.Trophic factors. These factors can promote neurogenesis and angiogenesis, stimulate progenitor cell proliferation, and prevent blood-brain barrier disruption. 
  
  Rehabilitation is an important part of recovery after a stroke. Rehabilitation can help stroke survivors regain the ability to walk, talk, and carry out daily tasks.

For decades, the occurrence of neurogenesis in the adult brain and the capacity to generate new neurons have been debated. However, a number of studies have provided clear evidence of neurogenesis in certain parts of the brain, such as the subgranular zone (SGZ) and subventricular zone (SVZ). Neural stem cells originating from these areas are considered to give rise to these new neurons. This is thought to be a critical process in post-stroke recovery and repair of the damaged brain region. In general, this involves the migration of neural stem cells to the infarct and peri-infarct region, followed by their differentiation into functional neurons. This ectopic migration begins 3-4 days after stroke onset is maintained until approximately four months of the damage

Age remains a prominent factor affecting neurogenesis. The rate of neurogenesis steadily declines with rising age, with stroke increasing the sharpness of that decline. 

The process of neurogenesis can generally be categorised into three stages: (1) neural stem cell proliferation, (2) migration of neuroblasts and immature neurons, and (3) differentiation into mature neurons and neurite extension, finally leading to synaptogenesis and stabilisation of the synapses. Stroke-induced neurogenesis presents a promising therapeutic target since it can allow the brain to, essentially, rewire and refresh itself and heal the damage caused by the ischemia or haemorrhage.

Since the neurogenic cascade is a highly regulated process, exposure to the ischemic environment may result in multiple dysfunctional outcomes. In fact, maladaptive neurogenesis could in some instances contribute as a secondary process to brain malfunctioning.

In contrast with the frequent spontaneous motor recovery during the chronic phase, cognitive function tends to worsen long-term after stroke due to cellular loss.