A review of therapeutic potentials in ischemic stroke.

Stroke is one of the leading causes of death in the world. There are as yet no effective treatments for the ischemic cerebral lesion itself. Nevertheless, five potential therapeutic objectives can be identified. For cerebral infarction, the best treatment is prevention, including targeted preventive treatments for specific subsets of patients or individuals with different risk factors. Incidence rates and mortality rates of stroke have been successfully reduced in certain developed countries by adoption of a public health approach to the prevention and control of risk factors. To rescue the still viable but injured nerve cells, within the ischemic penumbra, effective therapy should be begun at the earliest possible time. Measures to halt or reverse programmed cell death, to enhance the intrinsic autoprotective and repair mechanisms, are under active study. The existence of down-regulated brain regions, where normal nerve cells have far less activities to perform due to interruption of information exchange with the infarct area, and the possibility to reactivate them are worthy of attention.