Targeting the Brain: Neuroprotection and Neurorestoration in Ischemic Stroke

Jeffrey L. Saver, M.D., FAHA, FAAN


Pharmacotherapy. 2010;30(7):62S-69S. 

In This Article


Therapies targeting the neural parenchyma show great promise as synergistic complements to reperfusion therapies for acute ischemic stroke. As demonstrated with magnesium sulfate, neuroprotective agents can be started in the field hyperacutely, before hospital arrival, brain imaging, and reperfusion therapy, potentially freezing the ischemic penumbra and delivering to hospital-based interventionalists greater volumes of salvageable brain to save. In patients for whom acute brain resuscitation strategies provide insufficient relief, subacute neuroplasticity-enhancing therapies will soon (or perhaps with citicoline already do) facilitate brain repair and improved functional outcomes. With these approaches, it may be foreseen that physicians treating stroke in the future will plumb the depths of the mind literally and metaphorically, preserving threatened parenchyma with neuroprotective agents, reopening "blocked pipes" with lytics and mechanical devices, and stimulating brain plasticity and recovery with neuroreparative agents.