Department of Neurology, University of California, San Francisco and the San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Neurology, Tokai University School of Medicine, Isehara, Japan.
Department of Neurology, University of California, San Francisco and the San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
Exp Neurol. 2021 Apr;338:113599. doi: 10.1016/j.expneurol.2021.113599. Epub 2021 Jan 10.
Treatments for acute stroke have improved over the past years, but have largely been limited to revascularization strategies. The topic of neuroprotection, or strategies to limit brain tissue damage or even reverse it, has remained elusive. Thus, the clinical mainstays for stroke management have focused on prevention. The lack of clinical translation of neuroprotective therapies which have shown promise in the laboratory may, in part, be due to a historic inattention to comorbidities suffered by a majority of stroke patients. With the advent of more stroke models that include one or more relevant comorbidities, it may be possible to identify effective treatments that may translate into new treatments at the clinical level. In the meantime, we review comorbidities in stroke patients, modification of stroke risk factors and available acute stroke treatments in the clinic.
在过去的几年中,急性中风的治疗方法有所改善,但主要限于血管再通策略。神经保护的主题,即限制脑组织损伤甚至逆转它的策略,仍然难以捉摸。因此,中风管理的临床基础一直集中在预防上。在实验室中显示出前景的神经保护疗法在临床上未能得到广泛应用,部分原因可能是历史上对大多数中风患者所患的合并症重视不够。随着越来越多的中风模型包括一种或多种相关的合并症的出现,有可能确定有效的治疗方法,这些方法可能会转化为临床水平的新治疗方法。在此期间,我们回顾了中风患者的合并症、中风风险因素的改变以及临床上现有的急性中风治疗方法。