Apoptosis and programmed cell death: a role in cerebral ischemia.

Hypoxic-ischemic neuronal death has long been considered to represent necrosis, but it now appears that many brain neurons undergo apoptosis after either global or focal ischemic insults. Recent studies demonstrated: 1) DNA cleavage into oligonucleosome-sized fragments demonstrated by a typical ladder pattern; 2) early endonuclease activation, as demonstrated by the presence of high molecular weight DNA fragments (300 to 50 kbp); 3) chromatin condensation and apoptotic bodies formation; 4) activation of apoptosis-associated proteins. These results may indicate that apoptosis contributes to the development of the ischemic infarct and is probably substantially distinct from ischemia-triggered excitotoxicity, which tends to produce necrosis.