Current and future therapies for ischemic cerebrovascular disease

Stroke is the third leading cause of death in the adult population. It makes great demands on patients, who must not only survive the complications of the acute stages but also must cope with the great physical and economic costs of long-term disabilities. Therefore, there is an urgent need to establish generally useful treatments for ischemic stroke. Currently, there are three treatment approaches based on pathophysiologic concepts derived from basic research: (i) pharmacologic strategies for arterial recanalization, (ii) neuronal protection and (iii) the inhibition of undesirable damaging host responses. The key to current treatment is the emergent administration of tissue plasminogen activator (t-PA). Thrombolytic treatment improves outcome when given to carefully selected patients within 3 h of stroke onset. Numerous neuroprotective agents have been developed in the last decade, and a new wave of therapies is now on the horizon that could potentially minimize ischemic brain damage. This article highlights recent advances in pharmacological interventions for ischemic stroke. (C) 2000 Prous Science. Ail rights reserved.