Pathophysiology and therapeutic strategies in the management of stroke: an update.

Strokes, or brain attacks, which occur due to an interruption of blood flow in discrete regions of the brain, are a major cause of death. Stroke is the third leading cause of death and disability in developed nations. The complex pathophysiology of this medical problem includes excitotoxicity mechanisms, inflammatory pathways, oxidative damage and ionic imbalances. The final event is the ischemic neuronal death which results in an irreversible loss of the neuronal function. Recently, significant therapeutic advances have been made which include use of carotid endarterectomy, thrombolytics, anticoagulant therapy, antiplatelet agents, neuroprotective agents, and treating associated risk factors such as hypertension and hyperlipemia. However, in spite of the significant development in these areas of stroke research, none of the available therapeutic options are curative in that they can reduce the burden of stroke. This article briefly summarizes the status of advances made in order to understand the neurobiology of stroke and provide insight into the therapeutic strategies that could be developed for the effective management of ischemic stroke.