Therapeutic management of ischemic stroke

Naunyn Schmiedebergs Arch Pharmacol. 2024 May;397(5):2651-2679. doi: 10.1007/s00210-023-02804-y. Epub 2023 Nov 15.

Abstract

Stroke is the third leading cause of years lost due to disability and the second-largest cause of mortality worldwide. Most occurrences of stroke are brought on by the sudden occlusion of an artery (ischemic stroke), but sometimes they are brought on by bleeding into brain tissue after a blood vessel has ruptured (hemorrhagic stroke). Alteplase is the only therapy the American Food and Drug Administration has approved for ischemic stroke under the thrombolysis category. Current views as well as relevant clinical research on the diagnosis, assessment, and management of stroke are reviewed to suggest appropriate treatment strategies. We searched PubMed and Google Scholar for the available therapeutic regimes in the past, present, and future. With the advent of endovascular therapy in 2015 and intravenous thrombolysis in 1995, the therapeutic options for ischemic stroke have expanded significantly. A novel approach such as vagus nerve stimulation could be life-changing for many stroke patients. Therapeutic hypothermia, the process of cooling the body or brain to preserve organ integrity, is one of the most potent neuroprotectants in both clinical and preclinical contexts. The rapid intervention has been linked to more favorable clinical results. This study focuses on the pathogenesis of stroke, as well as its recent advancements, future prospects, and potential therapeutic targets in stroke therapy.

Keywords: Activated protein kinase C; Endovascular therapy; Human urinary kallidinogenase; Neuroprotective; Stem cell therapy; Stroke; Vagus nerve stimulation.

Publication types

  • Review

MeSH terms

  • Animals
  • Endovascular Procedures / methods
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Hypothermia, Induced / methods
  • Ischemic Stroke* / therapy
  • Neuroprotective Agents / therapeutic use
  • Thrombolytic Therapy / methods
  • Vagus Nerve Stimulation / methods

Substances

  • Neuroprotective Agents
  • Fibrinolytic Agents