Protection against ischaemia: the basis of acute stroke therapy.

The search for effective therapy of acute stroke, centres on the two strategies of restoring blood flow before ischaemia causes irreversible infarction, and moderation of the biochemical changes in ischaemic tissue that cause neuronal death. This review concentrates on the role of lactacidosis, calcium ions, free radicals, and excitatory neurotransmitters in the pathogenesis of neuronal death, and on the therapeutic possibilities in acute stroke emerging from studies in animal models.