Pathophysiology of ischemic brain injury.

This article reviews normal cellular function including ion homeostasis, cerebral metabolism, the utilization of glucose, and oxidative phosphorylation. A description of the types of cerebral ischemia is followed by the flow thresholds of ischemia, the concept of selective vulnerability, and the secondary biochemical and pathophysiologic consequences of ischemia. Pathophysiologically, cerebral ischemia includes both vascular and neuronal changes, which in turn reflect alterations in the mitochondria, intracellular ion concentrations, glucose, prostaglandins, free radicals, and excitatory amino acid neurotransmitters.