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Ischemic Stroke: Basic Pathophysiology and Neuroprotective Strategies

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Acute Ischemic Stroke

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1.12 Conclusion

Several complex and overlapping pathways underlie the pathophysiology of cell death after ischemic stoke. While pharmaceutical agents can inhibit these pathways at various levels, resulting in effective neuroprotection in experimental models, no single agent intended for neuroprotection has been shown to improve outcome in clinical stroke trials. Refinements in patient selection, brain imaging, and methods of drug delivery, as well as the use of more clinically relevant animal stroke models and use of combination therapies that target the entire neurovascular unit are warranted to make stroke neuroprotection an achievable goal. Ongoing trials assessing the efficacy of thrombolysis with neuroprotective agents, and strategies aimed at extending the therapeutic window for reperfusion therapy promise to enhance the known benefits of reperfusion therapy. Most investigators agree that genomics and proteomics are the most promising recent developments impacting the future of stroke prevention, diagnosis, treatment, and outcome. Although many challenges lie ahead, an attitude of cautious optimism seems justified at this time.

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Author information

Authors and Affiliations

  1. Stroke Service Department of Neurology and Neuroprotection Research Laboratory, Massachusetts General Hospital Harvard Medical School, Boston, Mass., USA

    Aneesh B. Singhal

  2. Neuroprotection Research Laboratory Departments of Radiology and Neurology, Massachusetts General Hospital Harvard Medical School, Charlestown, Mass., USA

    Eng H. Lo

  3. Department of Neurology, Faculty of Medicine Hacettepe University, Ankara, Turkey

    Turgay Dalkara

  4. Stroke and Neurovascular Regulation Laboratory Neuroscience Center Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., USA

    Michael A. Moskowitz

Authors
  1. Aneesh B. Singhal
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  2. Eng H. Lo
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  3. Turgay Dalkara
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  4. Michael A. Moskowitz
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Editor information

Editors and Affiliations

  1. Neuroradiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Mass., USA

    R. Gilberto González  & Michael H. Lev  & 

  2. Interventional Neuroradiology and Endovascular Neurosugery Service, Massachusetts General Hospital Harvard Medical School, Boston, Mass., USA

    Joshua A. Hirsch

  3. Acute Stroke Service, Massachusetts General Hospital, Fruit Street, Boston, MA, 02114, USA

    W.J. Koroshetz

  4. Neuroradiology, Massachusetts General Hospital, GRB 285, Fruit Street, Boston, MA, 02114-2696

    Pamela W. Schaefer

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Singhal, A.B., Lo, E.H., Dalkara, T., Moskowitz, M.A. (2006). Ischemic Stroke: Basic Pathophysiology and Neuroprotective Strategies. In: González, R.G., Hirsch, J.A., Koroshetz, W., Lev, M.H., Schaefer, P.W. (eds) Acute Ischemic Stroke. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-30810-5_1

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