Letter to the Editor. Effect of encephalomyosynangiosis procedure on post stroke recovery in a permanent model of ischemic stroke.

This correspondence comments on the methodological issues of Anthony et al. on encephalomyosynangiosis (EMS) for acute ischemic stroke in mice. The central issue is the clinically unrealistic intervention time of 4 h post-occlusion, which limits the translational relevance of the reported benefits in infarct reduction and recovery. Furthermore, the surgical design-specifically, the differential handling of the temporalis muscle between groups-introduces a potential confounder, as the excision in controls may alter baseline intracranial pressure compared to the preserved muscle in the EMS group. Details on sham procedures were also lacking. We suggest that employing a later, clinically pertinent time point and a more standardized surgical control would significantly strengthen the experimental model and the validity of its conclusions.