The Janus face of inflammation in ischemic brain injury.

Brain ischemia elicits an intense inflammatory reaction as evidenced by endogenous activation of microglia and infiltration of leukocytes from the systemic circulation into the brain. A key issue regarding the well-described inflammation in brain injury is whether this reaction is of salutary or detrimental nature in the short and longterm post ischemia. In this brief review, evidence in support for the possible beneficial as well as detrimental role of inflammatory cells and mediators in ischemic brain injury is highlighted. We offer the opinion that both benefits and adverse effects of the inflammatory reaction at large depent on the levels of a specific mediator, the temporal relationships to the injury, the context in which the mediator operates and the spatial relationships to the injury.