Pharmacological neuroprotection in cerebrovascular insufficiency: Possible approaches

Abstract

This review analyzed the literature data and results of our research on the experimental and clinical studies of the possibilities of pharmacological neuroprotection in ischemic brain lesions. Neuroprotection is one of the strategic directions of specific pharmacotherapy for cerebrovascular insufficiency. Different approaches to pharmacological neuroprotection are possible, considering the main pathogenetic pathways of the ischemic cascade and physiological mechanisms of neuroprotection. Pharmacological neuroprotection can be achieved by blocking the pathogenetic links of the ischemic cascade (primarily glutamate excitotoxicity and oxidant stress) and inducing physiological processes associated with neuroplasticity and neurotrophy. The issues related to the use of various pharmacotherapeutic groups for primary and secondary neuroprotection are discussed. The optimal choice of pathogenetic and physiological targets for primary and secondary pharmacological neuroprotection is an important component in the development of pharmacotherapy strategies for ischemic brain lesions because it consistently increases the resistance of brain cells to ischemia/hypoxia and stimulates reparative recovery processes in the central nervous system. Rationally selected pathways and drugs for pharmacological neuroprotection determine their effectiveness in ischemic brain lesions.