Neuroprotection in Acute Ischemic Stroke: A Battle Against the Biology of Nature
Sherief Ghozy, Abdullah Reda, Joseph Varney, Ahmed Sallam ElHawary, Jaffer Shah, Kimberly Murry, Mohamed Gomaa Sobeeh, Sandeep Samethadka Nayak, Ahmed Y. Azzam, Waleed Brinjikji, Ramanathan Kadirvel, David F. Kallmes
Abstract
Stroke is the second most common cause of global death following coronary artery disease. Time is crucial in managing stroke to reduce the rapidly progressing insult of the ischemic penumbra and the serious neurologic deficits that might follow it. Strokes are mainly either hemorrhagic or ischemic, with ischemic being the most common of all types of strokes. Thrombolytic therapy with recombinant tissue plasminogen activator and endovascular thrombectomy are the main types of management of acute ischemic stroke (AIS). In addition, there is a vital need for neuroprotection in the setting of AIS. Neuroprotective agents are important to investigate as they may reduce mortality, lessen disability, and improve quality of life after AIS. In our review, we will discuss the main types of management and the different modalities of neuroprotection, their mechanisms of action, and evidence of their effectiveness after ischemic stroke.