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Vascular Medicine
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Neuroprotection in acute ischaemic stroke. II: Clinical potential

Michelle Davis

Stroke Research Team, Queen Elizabeth Hospital, Gateshead, UK

David Barer

Stroke Research Team, Queen Elizabeth Hospital, Gateshead, UK

In the 4 years since our first article, there has been considerable progress in our understanding of the pathophysiology of acute ischaemic stroke, and the results of well-conducted trials have at last begun to change everyday clinical practice. The timing of the various processes of the ischaemic cascade and the potential time windows for different interventions are better understood. Furthermore, the importance of maintaining cerebral perfusion and optimizing systemic physiological and biochemical factors in order to prevent neurological deterioration (`progressing stroke') is increasingly being realized.

Numerous antithrombotic and neuroprotective drugs have been evaluated in clinical trials, and while none has shown unequivocal benefits on its own, prospects for successful intervention are still good. This will probably involve different combinations of treatments targeted on different pathophysiological stroke types, so that the management of acute stroke will offer a considerable challenge to the stroke physicians of the future.

Key Words: acute stroke/treatment • brain blood flow • brain ischaemia • brain protection • cerebral infarction • cerebral ischaemia • clinical trials • glutamate antagonists • ischaemic cascade • ischaemic penumbra • neuronal injury • N-methyl-d-aspartate

Vascular Medicine, Vol. 4, No. 3, 149-163 (1999)
DOI: 10.1177/1358836X9900400306
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M. L. Sacchetti
Is It Time to Definitely Abandon Neuroprotection in Acute Ischemic Stroke?
Stroke, June 1, 2008; 39(6): 1659 - 1660.
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