Treatment of experimental cerebral ischemia.

Abstract

The therapeutic amelioration of cerebrovascular insufficiency or ischemia is one of those domains in clinical neurology that is still far from being satis­ factorily solved. The situation is at a striking vari­ ance to the great number of publications in which experimental evidence has been provided for the beneficial effect of various vasoactive and anti­ ischemic/anoxic drugs. It is obvious that this dis­ crepancy must have something to do with the ex­ perimental conditions under which pharmacological drugs are tested , and it would be of great interest to know if the experimental models or the criteria used for assessing drug efficiency are unsatisfactory. In the following review, an attempt is made to clarify some of the problems involved. In the first part , the pathophysiology of cerebral ischemia is reviewed. The peculiarities of the various types of ischemia are discussed , and particular emphasis is given to those aspects that might be susceptible to therapeutic interference. In the second part , the animal models most commonly used for therapeuti­ cal studies will be critically reviewed and their rele­ vance will be discussed in respect to the pathophysiological principles described above. In the third part , various therapeutic procedures for ameliorating brain ischemia will be evaluated on the basis of published data obtained in animal experi­ ments , which, in our opinion , are relevant to the problem. Finally , future approaches will be dis­ cussed and recommendations will be given for im­ proving the significance of such studies. It should be pointed out that this editorial is strictly a per­ sonal view of the problem and that it is written by an