Abstract
Negative results of trials on the pharmacological treatment of acute ischemic stroke have represented a constant, distressing experience for the clinicians involved. In fact, none of the drugs effective in preventing or limiting cerebral ischemia in animals has thus far overcome the proof of a clinical trial. Nevertheless, the existence of an area of ischemic penumbra surrounding infarction (1), liable to complete recovery if blood flow is promptly restored, has been revealed by animal models. Moreover, knowledge on the cascade of events leading to irreversible neuronal death, through the final common pathway of intracellular calcium increase, also comes from experimental data (2). These acquisitions on the pathophysiology of cerebral ischemia are fundamental cornerstones on which a rational therapeutic approach should be based. In this light, two main strategies of pharmacological treatment, neuroprotection and early revascularization, appear currently suitable.
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References
Astrup J., Siesjo B.K. and Symon L. (1981): Stroke, 12: 723–725.
Siesjo B.K. (1981): J. Cereb. Blood Flow Metab., 1: 155–185.
Rothmans S.M. and Olney J.W. (1987): TINS, 10: 299–302.
Auer L.M. (1983): In: Cerebrovascular Diseases, edited by M. Reivich and H.I. Hurtin pp. 375–384. Raven Press, New York.
Gelmers H.J., Gorter K., De Weerdt C.J. and Wiezer H.J.A. (1988): New Engl. J. Med., 318: 203–207.
Martinez-Vila E., Guillen F., Villanueva J.A., Matias-Guiu, Bigorre J., Gil P., Carbonell A. and Martinez-Lage J.M. (1990): Stroke, 21: 1023–1028.
TRUST Study Group (1990): Lancet, 336: 1205–1209.
Bogousslavsky J., Regli F., Zumstein V. and Kobberling W. (1990): Eur. Neurol., 30: 23–26.
Pickard J.D., Murray G.D., Illingworth R., Shaw M.D.M., Teasdale G.M., Foy P.M., Humphrey P.R.D., Lang D.A., Nelson R., Richards P., Sinar, J., Bailey S. and Skene A. (1989): Br. Med. J., 298: 636–642.
Del Zoppo GJ., Ferbert A., Otis S., Bruckmann H., Hacke W., Zyroff J., Harker L.A. and Zeumer H. (1988): Stroke, 19: 307–313.
Haremberg J., Zimmermann R., Heuch C.C., Schmidt-Gayle U., Simon B. and Wahl P. (1980): In: Fibrinolysis and Urokinase, edited by V. Tilsner and H. Lenau pp. 391–404. Academic Press, London.
Zeumer H., Freitag H.C., Grzyska U. and Nuenzig H.-P. (1989): Neuroradiol., 31: 336–340.
Wilcox R.G., Von der Lippe G., Olssen C.G., Jensen G., Skene A.M. and Hampton J.R. (1988): Lancet, 2: 525–530.
Sloan, MA (1987): Arch. Neurol., 44: 748–768.
Zivin J.A., Lyden P.D., De Girolami U., Kochbar R., Mazzarella V., Hemenway C.C. and Johnston P. (1988): Arch. Neurol, 45: 387.
Fieschi C., Argentino C., Lenzi G.L., Sacchetti M.L., Toni D. and Bozzao L. (1989): J. Neurol. Sci., 91: 311–322.
Bozzao L., Fantozzi L.M., Bastianello S., Bozzao A., Argentina C., Lenzi G.L. and Fieschi C. (1989): Stroke, 20: 735–740.
Fieschi C., Argentino C., Lenzi G.L., Fantozzi L.M., Sacchetti M.L., Pace A., Rasura M., Bastianello S., Bozzao L., Zanette E., Buttinelli C., Giubilei F. and Pantano P. (1988): Ann. N.Y. Acad. Sci., 522: 662–666.
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© 1993 Springer Science+Business Media Dordrecht
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Fieschi, C. et al. (1993). Pharmacological Approach to Acute Ischemic Stroke. In: Godfraind, T., Paoletti, R., Govoni, S., Vanhoutte, P.M. (eds) Calcium Antagonists. Medical Science Symposia Series, vol 3. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-1725-8_36
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DOI: https://doi.org/10.1007/978-94-011-1725-8_36
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